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KEPRO - Beneficiary and Family Centered Quality Improvement Organization (BFCC-QIO)
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healthcare professionals Updates for Healthcare Providers
We are the Medicare Quality Improvement Organization, working to improve the quality of care for Medicare beneficiaries. Our site offers beneficiary and family-centered care information for providers, patients, and families. Welcome!

update

KEPRO is currently experiencing a high call volume. We understand that there have been delays in reviews as well as wait times for phone calls. Due to technical challenges with government-furnished computer systems and for provider ease, KEPRO will temporarily use a different fax number. Please pay close attention to the return fax number listed on the Medical Record Request documentation.

The Centers for Medicare & Medicaid Services instituted a new data entry system, which is not able to provide the necessary data for the online Case Status Update tool. Therefore, the online tool was discontinued on June 8, 2019.

Our staff is continuing to work hard to process all reviews and provide determinations, and we appreciate your patience during this transition period.

bfcc-qio changes that require action by healthcare providers

KEPRO has been the Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) in 33 states and the District of Columbia for the past five years and was recently awarded a new five-year contract by the Centers for Medicare & Medicaid Services (CMS) covering different states.

Effective June 8, 2019, KEPRO is the BFCC-QIO in those states that are shaded in the map below. See the table below for toll-free phone numbers.

As the BFCC-QIO, KEPRO will assist Medicare beneficiaries with quality of care complaints, hospital discharge and service termination appeals, and Immediate Advocacy.

If your facility is not in one of the shaded states below, Livanta is your BFCC-QIO effective June 8, 2019. These providers will need to update their appeals notices with Livanta's information.

Telephone, Fax Numbers and Mailing Addresses
Region 1
Connecticut
Massachusetts
Maine
New Hampshire
Rhode Island
Vermont
Region 4
Alabama
Florida
Georgia
Kentucky
Mississippi
North Carolina
South Carolina
Tennessee
Region 6
Arkansas
Louisiana
New Mexico
Oklahoma
Texas
Region 8
Colorado
Montana
North Dakota
South Dakota
Utah
Wyoming
Region 10
Alaska
Idaho
Oregon
Washington
Toll-free Phone
888-319-8452

Local Phone
216-447-9604

TTY
855-843-4776

Toll-free Fax
833-868-4055

Mailing Address
5700 Lombardo Center Dr.
Suite 100
Seven Hills, OH 44131
Toll-free Phone
888-317-0751

Local Phone
813-280-8256

TTY
855-843-4776

Toll-free Fax
833-868-4058

Mailing Address
5201 West Kennedy Blvd.
Suite 900
Tampa, FL 33609
Toll-free Phone
888-315-0636

Local Phone
216-447-9604

TTY
855-843-4776

Toll-free Fax
833-868-4060

Mailing Address
5201 West Kennedy Blvd.
Suite 900
Tampa, FL 33609
Toll-free Phone
888-317-0891

Local Phone
813-280-8256

TTY
855-843-4776

Toll-free Fax
833-868-4062

Mailing Address
5700 Lombardo Center Dr.
Suite 100
Seven Hills, OH 44131
Toll-free Phone
888-305-6759

Local Phone
813-280-8256

TTY
855-843-4776

Toll-free Fax
833-868-4064

Mailing Address
5700 Lombardo Center Dr.
Suite 100
Seven Hills, OH 44131

KEPRO will be continually updating this page with additional contact information, so check back frequently.

temporary pause of bfcc-qio short stay and higher weighted diagnosis-related group reviews

CMS has temporarily paused the performance of both Short Stay reviews and Higher Weighted Diagnosis-Related Group (HWDRG) reviews by the BFCC-QIOs. Short Stay reviews and HWDRG reviews stopped for a brief time on May 8, 2019.

CMS took this action to procure a new BFCC-QIO contractor. Two BFCC-QIOs have done HWDRG reviews since 2014 and Short Stay reviews since 2015 for all 50 states and 3 territories. Going forward, Short Stay reviews and HWDRG reviews will resume with a single organization performing reviews on a national basis. CMS anticipates a contract award to be issued by the 3rd quarter of calendar year 2019.

what actions do providers need to take?

If your facility is located in one of the states shaded in the map on this page, please

  1. Update Your Appeals Notices
    Acute care providers will need to update the Important Message from Medicare and post-acute providers will need to update the Notice of Medicare Non-coverage with KEPRO’s phone number for your region. See table on this page for phone numbers. Please note that it is acceptable to use labels to cover the existing BFCC information on the appeals notices.

  2. Complete a Memorandum of Agreement (MOA) and Provider Update Form
    Visit www.keproqio.com/moa to complete the MOA and Provider Update Form. All providers are required to complete a new MOA, even if one was submitted in 2014.

Resources:

MOA FAQ (PDF)

BFCC-QIO Transition FAQ (PDF)

Appeals Process Flow Chart (PDF)

For up-to-date information as available, subscribe to KEPRO's email list.




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